Hydroxychloroquine, chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions
MHRA advise clinicians to carefully consider benefits & risks before prescribing systemic azithromycin or other macrolides to patients on hydroxychloroquine or chloroquine. An observational study has shown co-administration is associated with increased cardiovascular mortality.
Source:
Medicines and Healthcare products Regulatory Agency
SPS commentary:
MHRA also reminds prescribers to be vigilant for psychiatric reactions associated with hydroxychloroquine or chloroquine, especially in the first month of treatment; as events have been reported in patients with no prior history of psychiatric disorders.
The review of data for cardiovascular safety has been published separately.